Misperceptions regarding protective barrier method use for safer sex among African-American women who have sex with women
Christina A. Muzny A C , Hanne S. Harbison A , Elizabeth S. Pembleton B , Edward W. HookA Division of Infectious Diseases, University of Alabama at Birmingham, 1530 3rd Avenue South, Birmingham, AL 35294, USA.
B Department of Epidemiology, University of Alabama at Birmingham, 1665 University Boulevard, Birmingham, AL 35294-0022, USA.
C Corresponding author. Email: cmuzny@uab.edu
Sexual Health 10(2) 138-141 https://doi.org/10.1071/SH12106
Submitted: 13 July 2012 Accepted: 16 October 2012 Published: 1 February 2013
Abstract
Background: Barrier methods for HIV and sexually transmissible infection (STI) prevention among women who have sex with women (WSW) are available, although their effectiveness has not been systematically investigated. These methods are infrequently used by WSW. As part of a larger study on STI risk perceptions and safer sex among African-American WSW, we discovered several misperceptions regarding barrier methods that may be associated with their limited use. Methods: Participants were recruited from the Jefferson County Health Department STI Clinic and through word of mouth in Birmingham, Alabama, for focus group discussions exploring perceptions of STI risk and safer sex. Results: Seven focus groups with 29 participants were conducted (age range: 19–43 years). Several misperceptions regarding barrier methods were identified, notably the conflation of dental dams and female condoms. Descriptions of the use of barrier methods were qualified with phrases suggesting their hypothetical, rather than actual, use. Additional evidence that barrier methods are not actually used came from beliefs that dental dams and female condoms are available in major grocery stores or department store chains. Conclusions: Those providing sexual health services to WSW should be cautious in assuming that WSW have accurate information regarding barrier methods for safer sex. Sexual health services provided to WSW should include an accurate description of what barrier methods are, how to distinguish them from barrier methods more commonly used during heterosexual sex (female and male condoms), and how to use them correctly. Future studies are needed to address how effectively these measures reduce transmission of STIs among WSW.
Additional keywords: Alabama, dental dam, female condom, lesbians, sex toys.
References
[1] US Department of Health and Human Services Centers for Disease Control and Prevention (CDC). HIV/AIDS among women who have sex with women. Atlanta: CDC; 2006. Available online at www.cdc.gov/hiv/topics/women/resources/factsheets/pdf/wsw.pdf [verified June 2012].[2] Richters J, Clayton S. The practical and symbolic purpose of dental dams in lesbian safer sex promotion. Sex Health 2010; 7 103–6.
| The practical and symbolic purpose of dental dams in lesbian safer sex promotion.Crossref | GoogleScholarGoogle Scholar | 20648734PubMed |
[3] Bailey JV, Farquhar C, Owen C, Mangtani P. Sexually transmitted infections in women who have sex with women. Sex Transm Infect 2004; 80 244–6.
| Sexually transmitted infections in women who have sex with women.Crossref | GoogleScholarGoogle Scholar | 15170014PubMed |
[4] Richters J, Prestage G, Schneider K, Clayton S. Do women use dental dams? Safer sex practices of lesbian and other women who have sex with women. Sex Health 2010; 7 165–9.
| Do women use dental dams? Safer sex practices of lesbian and other women who have sex with women.Crossref | GoogleScholarGoogle Scholar | 20465981PubMed |
[5] Muzny CA, Sunesara IR, Martin DH, Mena LA. Sexually transmitted infections and risk behaviors among African American women who have sex with women: does sex with men make a difference? Sex Transm Dis 2011; 38 1118–25.
| Sexually transmitted infections and risk behaviors among African American women who have sex with women: does sex with men make a difference?Crossref | GoogleScholarGoogle Scholar | 22082722PubMed |
[6] Schick V, Rosenerger JG, Herbenick D, Reece M. Sexual behavior and risk reduction strategies among a multinational sample of women who have sex with women. Sex Transm Inf 2012; 88 407–12.
| Sexual behavior and risk reduction strategies among a multinational sample of women who have sex with women.Crossref | GoogleScholarGoogle Scholar |
[7] Johnson SR, Guenther SM, Laube DW, Keettel WC. Factors influencing lesbian gynecologic care: a preliminary study. Am J Obstet Gynecol 1981; 140 20–8.
| 6894351PubMed |
[8] Robertson P, Schachter J. Failure to identify venereal disease in a lesbian population. Sex Transm Dis 1981; 8 75–6.
| Failure to identify venereal disease in a lesbian population.Crossref | GoogleScholarGoogle Scholar | 6894808PubMed |
[9] Johnson SR, Smith EM, Guenther SM. Comparison of gynecologic health care problems between lesbians and bisexual women: a survey of 2,345 women. J Reprod Med 1987; 32 805–11.
| 3430489PubMed |
[10] Edwards A, Thin RN. Sexually transmitted diseases in lesbians. Int J STD AIDS 1990; 1 178–81.
| 2083290PubMed |
[11] Rankow EJ. Lesbian health issues for the primary care provider. J Fam Pract 1995; 40 486–93.
| 7730774PubMed |
[12] Kellock D, O’Mahony CP. Sexually acquired metronidazole-resistant trichomoniasis in a lesbian couple. Genitourin Med 1996; 72 60–1.
| 8655171PubMed |
[13] Campos-Outcalt D, Hurwitz S. Female-to-female transmission of syphilis: a case report. Sex Transm Dis 2002; 29 119–20.
| Female-to-female transmission of syphilis: a case report.Crossref | GoogleScholarGoogle Scholar | 11818899PubMed |
[14] Marmor M, Weiss LR, Lyden M, Weiss SH, Saxinger WC, Spira TJ, et al Possible female-to-female transmission of human immunodeficiency virus. Ann Intern Med 1986; 105 969
| 3777723PubMed |
[15] Kwakwa HA, Ghobrial MW. Female-to-female transmission of human immunodeficiency virus. Clin Infect Dis 2003; 36 e40–1.
| Female-to-female transmission of human immunodeficiency virus.Crossref | GoogleScholarGoogle Scholar | 12539088PubMed |
[16] O’Hanlan KA, Crum CP. Human papillomavirus-associated cervical intraepithelial neoplasia following lesbian sex. Obstet Gynecol 1996; 88 702–3.
| Human papillomavirus-associated cervical intraepithelial neoplasia following lesbian sex.Crossref | GoogleScholarGoogle Scholar | 8841259PubMed |
[17] Ferris DG, Batish S, Wright TC, Cushing C, Scott EH. A neglected lesbian health concern: cervical neoplasia. J Fam Pract 1996; 43 581–4.
| 8969707PubMed |
[18] Pinto VM, Tancredi MV, Tancredi Neto A, Buchalla CM. Sexually transmitted disease/HIV risk behavior among women who have sex with women. AIDS 2005; 19 S64–9.
| Sexually transmitted disease/HIV risk behavior among women who have sex with women.Crossref | GoogleScholarGoogle Scholar | 16249657PubMed |
[19] Marrazzo JM, Koutsky LA, Handsfield HH. Characteristics of female sexually transmitted disease clinic clients who report same-sex behavior. Int J STD AIDS 2001; 12 41–6.
| Characteristics of female sexually transmitted disease clinic clients who report same-sex behavior.Crossref | GoogleScholarGoogle Scholar | 11177481PubMed |
[20] Fethers K, Marks C, Mindel A, Estcourt CS. Sexually transmitted infections and risk behaviors in women who have sex with women. Sex Transm Infect 2000; 76 345–9.
| Sexually transmitted infections and risk behaviors in women who have sex with women.Crossref | GoogleScholarGoogle Scholar | 11141849PubMed |
[21] Raiteri R, Fora R, Gioannini P, Russo R, Lucchini A, Terzi MG, et al Seroprevalence, risk factors, and attitude to HIV-1 in a representative sample of lesbians in Turin. Genitourin Med 1994; 70 200–5.
| 8039786PubMed |
[22] Marrazzo J, Stine K, Wald A. Prevalence and risk factors for infection with herpes simplex virus type-1 and -2 among lesbians. Sex Transm Dis 2003; 30 890–5.
| Prevalence and risk factors for infection with herpes simplex virus type-1 and -2 among lesbians.Crossref | GoogleScholarGoogle Scholar | 14646636PubMed |
[23] Marrazzo JM, Koutsky LA, Stine KL, Kuypers JM, Grubert TA, Galloway DA, et al Genital human papillomavirus infection in women who have sex with women. J Infect Dis 1998; 178 1604–9.
| Genital human papillomavirus infection in women who have sex with women.Crossref | GoogleScholarGoogle Scholar | 9815211PubMed |
[24] Marrazzo JM, Koutsky LA, Kiviat NB, Kuypers JM, Stine K. Papanicolaou test screening and prevalence of genital human papillomavirus among women who have sex with women. Am J Public Health 2001; 91 947–52.
| Papanicolaou test screening and prevalence of genital human papillomavirus among women who have sex with women.Crossref | GoogleScholarGoogle Scholar | 11392939PubMed |
[25] Lindley LL, Kerby MB, Nicholson TJ, Lu N. Sexual behaviors and sexually transmitted infections among self-identified lesbian and bisexual college women. J LGBT Health Res 2008; 3 41–54.
| Sexual behaviors and sexually transmitted infections among self-identified lesbian and bisexual college women.Crossref | GoogleScholarGoogle Scholar |
[26] Marrazzo JM. Barriers to infectious disease care among lesbians. Emerg Infect Dis 2004; 10 1974–8.
| Barriers to infectious disease care among lesbians.Crossref | GoogleScholarGoogle Scholar | 15550210PubMed |
[27] Muzny CA, Rivers CA, Mena LA, Schwebke JR. Genotypic characterization of Trichomonas vaginalis isolates among women who have sex with women in sexual partnerships. Sex Transm Dis 2012; 39 556–8.
| 22706219PubMed |
[28] Diamant AL, Schuster MA, McGuigan K, Lever J. Lesbians’ sexual history with men: implications for taking a sexual history. Arch Intern Med 1999; 159 2730–6.
| Lesbians’ sexual history with men: implications for taking a sexual history.Crossref | GoogleScholarGoogle Scholar | 10597764PubMed |
[29] Lemp GF, Jones M, Kellogg TA, Nieri GN, Anderson L, Withum D, et al HIV seroprevalence and risk behaviors among lesbians and bisexual women in San Francisco and Berkeley, California. Am J Public Health 1995; 85 1549–52.
| HIV seroprevalence and risk behaviors among lesbians and bisexual women in San Francisco and Berkeley, California.Crossref | GoogleScholarGoogle Scholar | 7485670PubMed |
[30] Koumans EH, Sternberg M, Bruce C, McQuillan G, Kendrick J, Sutton M, et al The prevalence of bacterial vaginosis in the United States, 2001–2004; associations with symptoms, sexual behaviors, and reproductive health. Sex Transm Dis 2007; 34 864–9.
| The prevalence of bacterial vaginosis in the United States, 2001–2004; associations with symptoms, sexual behaviors, and reproductive health.Crossref | GoogleScholarGoogle Scholar | 17621244PubMed |
[31] Marrazzo JM, Koutsky LA, Eschenbach DA, Agnew K, Stine K, Hillier SL. Characterization of vaginal flora and bacterial vaginosis in women who have sex with women. J Infect Dis 2002; 185 1307–13.
| Characterization of vaginal flora and bacterial vaginosis in women who have sex with women.Crossref | GoogleScholarGoogle Scholar | 12001048PubMed |
[32] Bailey JV, Farquhar C, Owen C. Bacterial vaginosis in lesbians and bisexual women. Sex Transm Dis 2004; 31 691–4.
| Bacterial vaginosis in lesbians and bisexual women.Crossref | GoogleScholarGoogle Scholar | 15502678PubMed |
[33] Marrazzo JM, Thomas KK, Agnew K, Ringwood K. Prevalence and risks for bacterial vaginosis in women who have sex with women. Sex Transm Dis 2010; 37 355–9.
[34] Eliason M, Schope R. Does “don’t ask don’t tell” apply to health care? Lesbian, gay, and bisexual people’s disclosure to health care providers. J Gay Lesbian Med Assoc 2001; 5 125–34.
| Does “don’t ask don’t tell” apply to health care? Lesbian, gay, and bisexual people’s disclosure to health care providers.Crossref | GoogleScholarGoogle Scholar |
[35] Obedin-Maliver J, Goldsmith ES, Stewart L, White W, Tran E, Brenman S, et al Lesbian, gay, bisexual, and transgender-related content in undergraduate medical education. JAMA 2011; 306 971–7.
| 21900137PubMed |
[36] Marrazzo JM, Thomas KK, Ringwood K. A behavioural intervention to reduce persistence of bacterial vaginosis among women who report sex with women: results of a randomized trial. Sex Transm Infect 2011; 87 399–405.
| A behavioural intervention to reduce persistence of bacterial vaginosis among women who report sex with women: results of a randomized trial.Crossref | GoogleScholarGoogle Scholar | 21653935PubMed |
[37] The Female Health Company (FHC). The Female Condom 2 leaflet. Chicago: FHC; 2012. Available online at: http://www.femalehealth.com [verified August 2012].